目的 探讨乐山市5岁以下儿童死亡原因及动态变化趋势及其相关因素，为制定科学有效的干预措施提供参考依据。 方法 对2005年－2010年5岁以下儿童死亡监测资料进行死亡率、构成比、死因顺位等相关因素分析。 结果 乐山市5岁以下儿童死亡率呈逐年下降趋势；2005年－2010年新生儿、婴儿、5岁以下儿童死亡率分别为7.22‰、10.78‰、13.64‰。死因主要为出生窒息、早产及低出生体重、肺炎等。 结论 强化围产期保健管理，建立健全产、儿科急救转运体系，加强各级医疗保健专业队伍的培训，是降低5岁以下儿童，特别是新生儿、婴儿死亡率的关键。
Objective To probe the clinical feature and complications of extraction of silicon oil after operation of simple rhegmatogenous retinal detachment in child patients. Methods The clinical materials of 22 patients (22 eyes) of child patients (5~14 years old) and 11 cases (11 eyes) of adult patients with simple rhegmatogenous retinal detachment undergone surgical treatment and subsequent retraction of silicon oil tampon, were reviewed and analyzed retrospectively. The reasons of extraction silicon tampon, ocular complications of intrao cular silicon tamponade and the changes of visual acuity pre- and post-extraction of silicon tamponade in above 2 groups were explored. Results The main reason for the extraction and complications of silicon oil tamponade were similar in both groups. The rate of occurrence of the complications in either group rose as time went on . There was no significant difference in change of visual acuity between two groups after the extraction of silicon oil tampon. Conclusion The responses to silicon oil after the operation for simple rhegmatogenous retinal detachment is quite similar in either children or adult patients,and there is no obvious difference between child and adult patients in the results of silicon oil extraction. (Chin J Ocul Fundus Dis，2000，16：139-212)
Objective To investigate the characteristics, complications, and influencing factors of pediatric foreign body ingestion, providing clinical references for prevention and management. Methods A retrospective analysis was conducted on pediatric cases of foreign body ingestion treated at West China Hospital of Sichuan University between June 2007 and September 2019. Patients were stratified by age into ≤5 years, 6-10 years, and >10 years groups. Foreign body types, impaction sites, and complication rates were compared across age groups. Univariate analysis and multivariate logistic regression were performed to identify risk factors for complications. Results A total of 610 pediatric cases of foreign body ingestion were enrolled. Foreign body ingestion predominantly occurred in children ≤5 years (n=472, 77.38%), followed by 6-10 years (n=100, 16.39%) and >10 years (n=38, 6.23%). Foreign body types varied significantly by age (P<0.05): coins predominated in ≤5-year-olds (57.20%), while food-related objects were most common in >10-year-olds (52.63%). The most frequent impaction site was the upper esophagus, accounting for 48.31%, 44.00%, and 60.53% in the three age groups, respectively. Univariate analysis identified age, foreign body type, and location as significant predictors of complications (P<0.05). Multivariate logistic regression demonstrated that oropharynx and esophageal impaction (reference: stomach) [odds ratio (OR)=4.699, 95% confidence interval (CI) (2.456, 8.996), P<0.001] and high-risk foreign body types [OR=3.538, 95%CI (2.045, 6.122), P<0.001] were independent risk factors for complications, whereas increasing age had a protective effect [OR=0.418, 95%CI (0.252, 0.694), P=0.001]. Conclusions Younger children are at higher risk of foreign body ingestion, while increasing age is protective against complications. High-risk foreign body types and oropharynx and esophageal impaction significantly increase complication risks. Strengthening parental education, preventive measures against high-risk objects, and enhancing clinicians’ vigilance for complex cases are essential to reduce complications.
With the popularization of digestive endoscopy in children, colonoscopy has been widely used. As the basis of digestive endoscopy, bowel preparation directly affects the diagnosis and treatment results of colonoscopy. Compared with adults, the functioning of important organs of children is immature, and their ability of cognition, communication and tolerance are weak. Their structure of the digestive tract is also significantly different in different ages. However, there have been no existing evidence-based guidelines on bowel preparation for digestive endoscopy of Chinese children. Therefore, it is important to develop evidence-based guidelines for bowel preparation combined with the clinical practice in China. In order to provide guidance and decision-making basis for Chinese pediatricians, we collaborated with multidisciplinary experts, based on existing evidence, adopted the grading of recommendations assessment, development and evaluation (GRADE) approach, followed the Reporting Items for Practice Guidelines in Healthcare (RIGHT) to develop this guideline for bowel preparation related to the diagnosis and treatment of children's digestive endoscopy.
Objective To summarize the experiences of surgical treatment of sinus venosus atrial septal defect （SVASD）. Methods There were 32 patients of SVASD, all of them were associated with totally or partially right anomalous pulmonary venous connection. There were 25 cases of superior SVASD, 22 cases underwent double-patch procedure, 3 cases underwent Warden procedure. In 7 cases of inferier SVASD, 3 cases of Scimitar syndrome underwent ASD repair by pericardial patch and at the same time the anomalous pulmonary vein was divided and reimplanted to the posterior wall of left atrium, 4 cases of them underwent single-patch ASD repair. Results The surgical results were satisfying and no patient died, 28 patients were in sinus rhythm and echocardiography showed neither obstruction of caval vein and right pulmonary vein nor residual interatrial shunt. Conclusion SVASD mostly associated with right anomalous pulmonary venous connection according to its special anatomic structure. Preserving the function of sinus node and avoiding of obstruction of caval vein should be routinely considered when superior SVASD was repaired. The heart function of Scimitar syndrome should be followed-up for a long time for it usually associated with right lung hypoplasia.
Objective To review the advances of livingrelated liver transplantation for children. MethodsOn the basis of the data in Kyoto university, the center of livingrelated liver transplantation in the world, the current situation of livingrelated liver transplantation for children were investigated. ResultsEighty percent of patients who underwent the livingrelated liver transplantation were children with cholestatic liver disease. From the data of 462 cases, the patients’survival rate for 1, 3 and 5 years after livingrelated liver transplantation (79.8%, 77.0% and 77.0% respectively) preceded the survival rate of 129 patients who underwent the whole liver transplantation (76.0%, 70.0% and 65.0% respectively). To the livingrelated liver transplantation, the survival rate was higher for patients who underwent selective operation (85.0%) than emergency surgery (67.0%). The principal causes of death were rejection and infection. Furthermore, a partial orthotopic liver transplantation and livingrelated liver replantation were performed for children. Conclusion Strict indication, optimal health status and perfect postoperative management are the keys to keep patients longterm healthy survival. The curative effect of livingrelated liver transplantation precedes the whole liver transplantation. For children, livingrelated liver transplantation is better than for adults.